新型冠状病毒肺炎对神经系统影响的中医认识  

TCM Interpretation of COVID-19 Influence on Nervous System

作　　者：任非非 郭蓉娟[2] REN Feifei;GUO Rongjuan(Beijing University of Chinese Medicine,Beijing China 100029;Dongfang Hospital Beijing University of Chinese Medicine,Beijing China 100078)

机构地区：[1]北京中医药大学,北京100029 [2]北京中医药大学东方医院,北京100078

出　　处：《中医学报》2021年第2期231-235,共5页Acta Chinese Medicine

基　　金：北京市自然科学基金项目(7202120);北京中医药大学优秀传承团队——王永炎名医传承工作站建设项目(1000062720028/010)。

摘　　要：新型冠状病毒可入侵脑内,通过影响神经系统血管紧张素转换酶2受体功能导致疾病发生或加重。中医疫戾之邪发病急骤,传变迅速,易伤脑神而发为脑病。脑与肺脾以经络相连,生理功能和病理改变均密切相关。针对新型冠状病毒肺炎对神经系统影响的特点,其防治策略需注意以下几点:(1)针对既往无脑血管系统基础性疾病的患者,充分发挥中医"治未病"优势,未病先防,可利用饮食、运动、调畅情志等生活方式预防脑病发生。(2)对于有脑血管系统基础疾病或存在脑血管病发生高危因素的患者,在保持原治疗方案的基础上,以中医脑病治疗常用之治风法、祛湿法、祛痰法、活血化瘀法及补益法等辨证治疗。(3)对于重症与危重症患者,若病情进展出现窍闭神昏表现,或出现厥证和脱证等危象,可紧急给予回阳救逆之法,常用方剂如参附汤、独参汤及四逆辈等,必要时可鼻饲给药。对于神志昏迷者,也可用醒神开窍法以苏醒神志,如安宫牛黄丸、苏合香丸等,或给予醒神开窍针刺救急治疗。(4)全程注重调气以治神,辨治脑病首重调神,而调神之法首在调气。The corona virus disease 2019(COVID-19)can invade the brain and cause or worsen diseases by affecting the function of the angiotensin-converting enzyme 2(ACE2)receptor in the nervous system.In TCM,the outbreak of epidemic pathogen is acute,and its rapid transmission would damage the brain and then leads to encephalopathy.The brain,Lungs and Spleen are connected by meridians,and their physiological functions and pathological changes are deeply correlated.Based on the characteristics of the impact of COVID-19 on the nervous system,its prevention and treatment strategies need to pay attention to the following points:(1)For patients without underlying diseases history of the cerebrovascular system,we should maximize the advantages of TCM"preventive treatment of disease"in to prevent illness from occuaance.The interventions of lifestyle such as diet,exercise,and emotional adjustment can also be used to prevent encephalopathy.(2)For patients with basic cerebrovascular system diseases or high-risk factors for cerebrovascular illnesses,in addition to the original treatment plan,the common treatments of encephalopathy in TCM such as dispel Wind-dispelling method,Dampness-dispelling method,Phlegm-dispelling method,activate blood and resolve stasis,tonifying and replenishing method can be used in treatment according to syndrome differentiation.(3)For patients in severe or critical conditions,if the diseases aggravates and shows symptoms of orifices block and loss of consciousness,or syncope and collapse crisis,method of restoring Yang to save from collapse can be used as an emergency treatment.Common prescriptions include Shenfu Decoction,Dushen Decoction and Sini Decoction,etc.If condition allows,nasogastric gavage can be used.For those in coma,the method of wake the spirit and open the orifices can also be used for resuscitation,which prescriptions include Angongniuhuang Pill and Suhexiang Pill,etc.In addition,Xingshenkaiqiao acupuncture can be used as an emergency recusation.(4)The whole treatment focuses on regulating Q

关 键 词：新型冠状病毒肺炎 神经系统 脑血管病 治未病 调气 调神 回阳救逆 

分 类 号：R256.1[医药卫生—中医内科学]